Rates of ear infections have fallen sharply since two new vaccines hit the market, researchers reported Monday.
In 1989, 80 percent of U.S. children got at least one ear infection. Now it’s 60 percent, the researchers report in the journal Pediatrics.
Parents can thank vaccines called pneumococcal vaccines — sold under the brand names Prevnar and Pneumovax. They protect kids and older adults against bacteria that cause pneumonia, meningitis and ear infections.
While most kids still get an ear infection or two by age 3, the study found many fewer had repeat infections — just 24 percent had three or more infections, the researchers found.
They found something else: if they drained the infected ear fluid, they could treat a child’s specific infection better, and the children were less likely to have repeat infections. But it’s not something pediatricians usually do, said Dr. Michael Pichichero of the Rochester General Hospital and Legacy Pediatrics, who led the study team.
Testing the fluid allowed doctors to determine which specific germ was causing the infection, and to treat is with an antibiotic that has been shown to work against the particular bacteria. But it does involve minor surgery.
“Very few doctors can do it,” Pichichero said.
“It’s not hard at all. You put novocaine on the eardrum and the child doesn’t feel any pain but you do have to be trained.”
Middle ear infections — what doctors call otitis media — lead to around 30 million visits to the doctor each year, and they're the most common reason for prescribing antibiotics to children.
“It is the most common condition treated with antibiotics, and increasing incidence of antibiotic resistance among the organisms responsible for otitis media is a cause for concern,” Pichichero’s team wrote.
Pichichero’s team studied followed 615 children who visited their clinic over 10 years. “By 1 year of age, 23 percent of the children experienced one or more episode of acute otitis media; by 3 years of age, 60 percent had one or more episodes of acute otitis media,” they wrote.
It’s hard to figure out the effects of vaccinating children since most children are vaccinated against Streptocococcus pneumoniae. Plus, the American Academy of Pediatrics has tightened the definition of acute otitis media — ear infections.
But back in the 1980s, before Prevnar and Pneumovax were available, Boston researchers did a big study that found 80 percent of kids had an ear infection by age 3 and 40 percent had three or more ear infections.
“A significant decrease of acute otitis media cases appears to have occurred by comparing the results from the current situation,” Pichichero and colleagues concluded.
Now the leading causes of ear infections are bacteria that children do not get vaccinated against: a strain of Haemophilus influenza not in the current vaccine, and another germ called Moraxella catarrhalis, Pichichero said. Some are also caused by viruses.
Most ear infections go away on their own without treatment, according to the Centers for Disease Control and Prevention.
When do you take your child to the pediatrician or clinic?
The CDC says:
- When temperature goes higher than 102.2 °F
- If fluid, blood or pus is coming out of the ears
- If symptoms worsen or don’t get better after two or three days
- If a baby under three months has a fever
Pichichero makes another controversial assertion. The American Academy of Pediatrics recommends using the antibiotic amoxicillin to treat infections that do need antibiotics. But he says amoxicillin doesn’t kill M. catarrhalis or H. influenza. Instead, his team uses Augmentin, which pairs amoxicillin with another drug called clavulanate potassium.
“If you use amoxicillin (alone) you are not going to cure almost half the ear infections,” Pichichero said.
Not everyone agrees that’s been proven. “The best choice of antibiotic therapy, however, remains unclear,” Dr. Richard Wasserman of the University of Vermont and Dr. Jeffrey Gerber of the Children’s Hospital of Philadelphia wrote in a commentary.
It’s clear the vaccines have reduced rates of ear infections, they said, and ear taps are safe if parents want to do them, they said.